Close to half of New Jersey's adult population either has diabetes or is one step away from the irreversible diagnosis.

And most of these folks don't even know it.

According to 2019 figures from the American Diabetes Association, approximately 862,000 people in New Jersey have the chronic disease, which affects a body's ability to produce or use the hormone insulin. More than 2.4 million other Garden State residents, meanwhile, have prediabetes blood glucose levels are higher than normal, but not yet high enough to be counted as a full-blown diabetes diagnosis.

It's believed that a little more than a quarter of diabetic adults are not aware of their condition, along with 90% of folks living with prediabetes.

"The key to really being able to prevent or manage diabetes is understanding your risk," said Lauren Grosz, executive director of the association's New Jersey and New York City markets. "If people are at high risk, we encourage them to see their doctor and get a blood test."

Every year in New Jersey, the association said, an estimated 39,000 people are diagnosed with diabetes.

With the diagnosis, individuals are at greater risk for other serious complications such as heart disease, stroke, end-stage kidney disease and blindness.

As part of American Diabetes Month, the association launched a campaign called Count Me In, which encourages those impacted by the disease to "get involved in the fight" by volunteering, becoming advocates and donating to the cause, and urges those who may be at risk to speak with their physician.

People with diabetes incur medical expenses more than two times higher than those who do not have diabetes, the association said. In New Jersey, total direct medical costs related to diagnosed diabetes were estimated at $6.7 billion in 2017.

Affordability is the biggest barrier to care for suffering individuals who do not have health insurance, according to the Diabetes Foundation. And whether or not someone has insurance, the foundation said, insulin is expensive.

"Depending on the type of insulin, the costs could be overwhelming," said Ginine Cilente, executive director of the Hackensack-based foundation, which helps people manage the disease and provides short-term medication for those who can't afford it.

The foundation's youngest participant last year was 3 years old. The oldest was 95.

"Diabetes is hard, and we think getting help shouldn't be," Cilente said. "We have come across a lot of people who say they are rationing their insulin."

Diabetes is the eighth leading cause of death in the Garden State, and the rate of new adult cases is increasing, according to the Department of Health.

The state says it is making progress in reducing the diabetes death rate, and increasing the percentage of diabetic adults who get an A1C test at least twice a year.